ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2023
Metrics of dose to highly ventilated lung are predictive of radiation-induced pneumonitis in lung cancer patients.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 20 citations in OpenAlex.
- Predicting End-of-Treatment Ventilation Response to Radiation Therapy Using Early Treatment Ventilation for Patients With Lung Cancer Treated With Photons and Protons.International journal of radiation oncology, biology, physics · 2026Article
- Quantitative lung tissue functional analysis for pulmonary adverse event risk assessment prior to thoracic radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Computed tomography-based deep learning prediction of radiation-induced functional decline after lung cancer radiotherapy.Translational lung cancer research · 2026Article
- Article
- Four-dimensional computed tomography ventilation imaging-guided radiotherapy planning in different techniques for lung cancer.Frontiers in oncology · 2026Article
- Weekly changes in ventilation response for photon and proton lung cancer patients during radiotherapy.medRxiv : the preprint server for health sciences · 2025Article
- [Research progress on predicting radiation pneumonia based on four-dimensional computed tomography ventilation imaging in lung cancer radiotherapy].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2025Review
- Functional Imaging of Changes in Lung Function Before and After Radiation Therapy of Lung Cancer.Advances in radiation oncology · 2025Article
- Advances in noninvasive imaging for detecting radiation-induced lung injury (RILI).International journal of radiation biology · 2025Review
- Hybrid method for estimating lung ventilation from CT by combining intensity and motion information.Medical physics · 2025Article
- Dosimetric Predictors of Acute Radiation Pneumonitis and Esophagitis in Hypofractionated Thoracic Irradiation of Non-Small Cell Lung Cancer Patients With Poor Prognostic Factors.Advances in radiation oncology · 2025Article
- Development of a nomogram for predicting radiation‑induced pneumonia in patients with lung cancer undergoing close‑range radiotherapy with radioactiveMolecular and clinical oncology · 2025Article
- Abscopal effect: from a rare phenomenon to a new frontier in cancer therapy.Biomarker research · 2024Review
- COPD and Immune Checkpoint Inhibitors for Cancer: A Literature Review.International journal of chronic obstructive pulmonary disease · 2024Review
- Validation of CT-based ventilation and perfusion biomarkers with histopathology confirms radiation-induced pulmonary changes in a porcine model.Scientific reports · 2023Article
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12 authors at 5 institutions in 1 country.
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Abstract
purposeTo identify metrics of radiation dose delivered to highly ventilated lung that are predictive of radiation-induced pneumonitis. METHODS AND MATERIALS: A cohort of 90 patients with locally advanced non-small cell lung cancer treated with standard fractionated radiation therapy (RT) (60-66 Gy in 30-33 fractions) were evaluated. Regional lung ventilation was determined from pre-RT 4-dimensional computed tomography (4DCT) using the Jacobian determinant of a B-spline deformable image registration to estimate lung tissue expansion during respiration. Multiple voxel-wise population- and individual-based thresholds for defining high functioning lung were considered. Mean dose and volumes receiving dose ≥ 5-60 Gy were analyzed for both total lung-ITV (MLD,V5-V60) and highly ventilated functional lung-ITV (fMLD,fV5-fV60). The primary endpoint was symptomatic grade 2+ (G2+) pneumonitis. Receiver operator curve (ROC) analyses were used to identify predictors of pneumonitis.
resultsG2+ pneumonitis occurred in 22.2% of patients, with no differences between stage, smoking status, COPD, or chemo/immunotherapy use between G<2 and G2+ patients (P≥ 0.18). Highly ventilated lung was defined as voxels exceeding the population-wide median of 18% voxel-level expansion. All total and functional metrics were significantly different between patients with and without pneumonitis (P≤ 0.039). Optimal ROC points predicting pneumonitis from functional lung dose were fMLD ≤ 12.3 Gy, fV5 ≤ 54% and fV20 ≤ 19 %. Patients with fMLD ≤ 12.3 Gy had a 14% risk of developing G2+ pneumonitis whereas risk significantly increased to 35% for those with fMLD > 12.3 Gy (P = 0.035).
conclusionsDose to highly ventilated lung is associated with symptomatic pneumonitis and treatment planning strategies should focus on limiting dose to functional regions. These findings provide important metrics to be used in functional lung avoidance RT planning and designing clinical trials.
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